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Author: | Byrne, M.M. Thompson, P. |
Title: | Death and dignity - Terminal illness and the market for non-treatment |
Journal: | Journal of Public Economics
2000 : MAY, VOL. 76:2, p. 263-294 |
Index terms: | Insurance Costs Quality of life Ethics Models |
Freeterms: | Health care |
Language: | eng |
Abstract: | This paper constructs a stochastic model of illness, death and treatment choice to analyze 2 proposals - legally-binding advance directives and insurer-paid compensation schemes - to reduce the incidence of aggressive and possibly futile end-of-life treatment. It is assessed whether, in a competitive insurance market, the proposals are consistent with: 1. individual rationality in selection of competitive insurance contracts, 2. medically ethical treatment provision, and 3. reductions in end-of-life expenditures. It is concluded that binding advance directives are always medically unethical, while compensation schemes are medically ethical. The compensation schedule arising in a competitive equilibrium is derived, and it is shown that it reduces aggressive treatment and satisfies individual rationality. |
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